Introduction: Oesophageal duplication (OD) is a rare congenital abnormality that arises during the third week of embryonic life. Between 25–30% of patients remain undiagnosed until adulthood. The most common site is in the middle oesophagus. Methods: A 35-year-old woman was admitted complaining of dysphagia, epigastric pain and vomiting. Chest CT showed mid- oesophageal pseudodiverticulum with oesophageal double lumen from the thoracic inlet to the diverticulum. Oesophagoscophy revealed a true oesophageal lumen and pseudodiverticulum. Oesophagogram showed double lumen extending to the diaphragm. Bronchoscopy and abdominal ultrasound were normal. Results: Surgical findings confirmed OD. Adhesions to mediastinal organs were present. The oesophagus was isolated, pseudodiverticulum with the mucosal duplication resected and the muscle coat reconstructed. The postoperative recovery was swift, discharge in 10 days. Follow-up at one year with a chest X-ray confirmed normal oesophageal lumen. The patient remains symptom-free. Discussion: With OD the primary oesophagus and duplication are in the same muscle sheath and may communicate. Malignant degeneration has been reported. Two-thirds present with dysphagia and chest pain. Mediastinal mass and oesophageal diverticulum are the differential diagnoses. Chest radiograph reveals a mediastinal mass, oesophagogram shows abnormal oesophageal transit and some- times double lumen if communicating with the oesophagus. CT scan is the gold standard. Oesophagoscopy occasionally might show the inlet and the possible outlet between duplication and oesophagus. Biopsy is contraindicated. Treatment, in symptomatic patients, is surgical and consists in the excision of the duplication with preservation of the muscular layer. Results are good with complete resolution of symptoms.
Di Carlo L, Semeraro A, Daddi N, Sciamannini M, Lomonaco A, Puma F, et al. (2006). Oesophageal Duplication: A Case Report. Karger.
Oesophageal Duplication: A Case Report
DADDI, NICCOLO';
2006
Abstract
Introduction: Oesophageal duplication (OD) is a rare congenital abnormality that arises during the third week of embryonic life. Between 25–30% of patients remain undiagnosed until adulthood. The most common site is in the middle oesophagus. Methods: A 35-year-old woman was admitted complaining of dysphagia, epigastric pain and vomiting. Chest CT showed mid- oesophageal pseudodiverticulum with oesophageal double lumen from the thoracic inlet to the diverticulum. Oesophagoscophy revealed a true oesophageal lumen and pseudodiverticulum. Oesophagogram showed double lumen extending to the diaphragm. Bronchoscopy and abdominal ultrasound were normal. Results: Surgical findings confirmed OD. Adhesions to mediastinal organs were present. The oesophagus was isolated, pseudodiverticulum with the mucosal duplication resected and the muscle coat reconstructed. The postoperative recovery was swift, discharge in 10 days. Follow-up at one year with a chest X-ray confirmed normal oesophageal lumen. The patient remains symptom-free. Discussion: With OD the primary oesophagus and duplication are in the same muscle sheath and may communicate. Malignant degeneration has been reported. Two-thirds present with dysphagia and chest pain. Mediastinal mass and oesophageal diverticulum are the differential diagnoses. Chest radiograph reveals a mediastinal mass, oesophagogram shows abnormal oesophageal transit and some- times double lumen if communicating with the oesophagus. CT scan is the gold standard. Oesophagoscopy occasionally might show the inlet and the possible outlet between duplication and oesophagus. Biopsy is contraindicated. Treatment, in symptomatic patients, is surgical and consists in the excision of the duplication with preservation of the muscular layer. Results are good with complete resolution of symptoms.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
